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Can diet fix PCOS to get pregnant?

Whilst not often discussed, PCOS is a lot more common than people may think. It is a condition that affects 1 in 5 women of childbearing age and can have a profound effect on a woman’s fertility. Without any symptoms being present it can be difficult to identify and subsequently difficult to become pregnant.

Studies have shown that weight loss and diet are the primary focus when it comes to managing the condition. However, there is a lot of conflicting advice that exists so we asked our experts nutritionist Melanie McGrice and Fertility Specialist Dr Timothy O’Dowd to set the record straight:

From a nutritionist’s perspective, Melanie emphasises that diet is the most important thing to consider when you have PCOS. A significant amount of women who have PCOS have what’s called insulin resistance. Insulin is the hormone that allows your body to process sugar, when it’s disrupted it can impact your fertility hormones that ultimately affect how regularly you ovulate - making it difficult to conceive.

Not everyone who has PCOS is overweight, in fact many women can be at a healthy weight but have a high percentage of body fat. This can be optimised through diet, particularly managing your glycaemic load. Your glycaemic load is a number that estimates how much carbohydrate intake raises a person’s blood glucose level, so by maintaining accurate levels your body can produce the right amount of insulin throughout the day so that you are able to optimise ovulation again. 

So what should you eat? 

Focusing on Low-GI foods such as whole grains, ancient grains and legumes are fantastic options for women with PCOS because they contain protein and fibre and have a slow release of good carbohydrates. The Mediterranean diet is a great example of the type of foods to stick to especially fish, low starch vegetables, green salads and sweet potato as they have various nutritional benefits.

Though it is important to remember that each woman is different with differing dietary requirements outside PCOS management. “When a woman first presents to me with PCOS, I tend to look at a few different things such as existing medical and dietary conditions, so I can optimise those dietary requirements to ensure that she is absorbing nutrients correctly whilst also correcting any deficiencies” says Melanie. “Secondly, we really want to optimise her weight for fertility, whether that means losing or gaining weight as this too has a significant impact upon the likelihood of conceiving” explains Melanie. 

From a fertility perspective, Dr Timothy O’Dowd explains that diet and lifestyle are the first point of assessment when evaluating a woman’s PCOS. When diagnosing PCOS you are looking for a specific set of criteria, this includes polycystic ovaries that are visible on an ultrasound scan, evidence of abnormal menstrual functions and presence of testosterone that can be evident via acne, excess hair growth and blood test abnormalities.

Diet can have a profound effect on PCOS, Professor Norman from Australia was one of the first to show this. He trialled a group of women who were clinically diagnosed as obese and had PCOS into an exercise and dietary program. The percentage of women who lost between 5 and 10 percent of their weight resumed ovulation and regular periods. More recent works reflect this same notion, but with more targeted dieting styles such as low-carb healthy fat or the ketogenic diet.

If you have PCOS and want to conceive the best first step is to make healthy lifestyle changes. Of course this is heavily dependent on diet and focusing on reducing insulin resistance, quitting smoking and exercising regularly. For any woman who is trying to become pregnant, she should be advised to take prenatal supplements and get her various bloods checked. In the meantime, it is important that she understands her cycle and timing intercourse. If further action is required they may move onto ovulation induction and potentially suggest an IVF program.  

Your chance of conceiving when you have PCOS is completely dependent on your cycle. If you’re having regular intercourse and it happens to overlap during a time when you are in fact ovulating, generally speaking your fertility ability is OK. The problem lies within the infrequence of ovulation and the unpredictability of timing intercourse.

If you know or suspect you have PCOS and have been trying to conceive for more than 12 months (6 months if you are over 35) you may want to consider speaking with a fertility specialist, select your location below for more information:

NSWVIC / QLD / TAS / SGP

For more nutritional advice check out Melanie’s top tips below: